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The Impact of Multivitamin-Multimineral Supplements: A Comprehensive Review
Multivitamin-Multimineral Supplements and Mortality Risk
No Significant Effect on Mortality
A meta-analysis of randomized controlled trials involving 91,074 participants found that multivitamin-multimineral supplementation had no significant effect on all-cause mortality. The relative risk (RR) was 0.98 with a 95% confidence interval (CI) of 0.94 to 1.02, indicating no increased or decreased risk of death from any cause . Additionally, the study observed no effect on mortality due to vascular causes or cancer .
Nutrient Intake and Adequacy
Contribution to Total Nutrient Intake
Multivitamin-multimineral supplements significantly contribute to total nutrient intake. In the Hawaii-Los Angeles Multiethnic Cohort, supplement users showed an 8 percentage point improvement in nutrient adequacy compared to non-users. However, users were also more likely to have potentially excessive intakes of certain nutrients like iron, zinc, vitamin A, and niacin .
Cognitive Function and Multivitamin Use
Mixed Results on Cognitive Performance
Research on the cognitive benefits of multivitamin supplementation presents mixed results. A systematic review and meta-analysis found that multivitamins improved immediate free recall memory but had no significant effect on delayed free recall memory or verbal fluency . Another long-term study involving male physicians aged 65 and older found no cognitive benefits from daily multivitamin use over a 12-year period . Similarly, a 16-week trial in older adults showed improvements in blood biomarkers but no cognitive enhancements .
Safety and Long-Term Use
Safe for Long-Term Use
Multiple studies have evaluated the safety of long-term multivitamin-multimineral supplementation. These studies generally report only minor adverse effects, such as gastrointestinal symptoms, and no significant differences in adverse events between treatment and placebo groups Biesalski2017Biesalski2016. The use of these supplements within the recommended dietary allowance does not result in excess intake and does not increase mortality Biesalski2017Biesalski2016.
Special Populations: Pregnant Women and HIV-Infected Individuals
Benefits for Pregnant Women and HIV-Infected Individuals
Multivitamin-multimineral supplements are particularly beneficial for pregnant women and HIV-infected individuals. In pregnant women, these supplements, combined with iron and folic acid, improve birth outcomes and reduce the rates of low birth weight and miscarriage Biesalski2017Biesalski2016. For HIV-infected women and their children, multivitamin supplementation significantly improved hematologic status, reducing the risk of anemia and increasing hemoglobin concentrations .
Conclusion
Multivitamin-multimineral supplements are widely used and contribute significantly to nutrient intake. While they do not appear to affect mortality rates or provide cognitive benefits in the general population, they are safe for long-term use and offer specific health benefits for pregnant women and HIV-infected individuals. Further research is needed to fully understand their impact on various health outcomes.
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